Free Flap Fat Volume is Not Associated With Recurrence or Wound Complications in Oral Cancer

Area of Science:

• Oncology
• Plastic Surgery
• Regenerative Medicine

Background:

• Adipose stem cells (ASCs) show immunomodulatory properties in preclinical research.
• Clinical data on adipose tissue's effect on cancer recurrence after reconstruction is conflicting.
• The role of adipose content in reconstructive surgery for oral squamous cell carcinoma (OSCC) remains unclear.

Purpose of the Study:

• To investigate the association between adipose content in free flaps and disease recurrence in OSCC patients.
• To determine if free flap fat volume correlates with wound healing complications after OSCC reconstruction.

Main Methods:

• Retrospective chart review of 55 patients undergoing free flap reconstruction for OSCC.
• Quantitative assessment of relative free flap fat volume (FFFV) using texture analysis on postoperative CT scans.
• Comparison of FFFV with patient survival, cancer recurrence rates, and wound healing complications.

Main Results:

• No significant difference in mean FFFV was observed between patients who recurred and those who remained cancer-free (17.99 cm³ vs. 13.47 cm³).
• Two-year recurrence-free survival rates were similar for patients with high and low FFFV (61.0% vs. 59.1%).
• No trend was identified between FFFV and the incidence of wound healing complications.

Conclusions:

• Free flap fat volume (FFFV) is not associated with cancer recurrence in OSCC patients.
• Adipose content in free flaps does not appear to influence wound healing complications.
• Reconstructive surgeons can consider adipose content in free flaps without concern for oncologic or wound healing outcomes in OSCC.